Standard practices in operating room calls for delivering to the operating theater, containers of different shapes/volume prefilled with a fixative, in the large majority of cases NBF formalin 10%. During the operation biospecimens from the patient must be placed by the nurses in such containers. Opening the container in the operating room exposes the operating room team to the toxic and cancer-provoking fumes of formalin.
The declaration recently issued by the International Agency for Research on Cancer (International Agency for Research on Cancer (2006), Monographs on the evaluation of Carcinogenic Risk to humans. (IARC, Vol. 88) Lyon, France), which classified formaldehyde as a Class 1 carcinogenic has increased the request by health authorities, technicians and practicing pathologists to entirely avoid or at least substantially reduce contact with formalin. The standard use of formalin (formaldehyde) as well as other fixative reagents is encountering increasing criticisms because of toxicity and environmental concerns.
Several other disadvantages are present in this sequence of events:                1) Often biospecimens are not placed immediately in the fixative solution. Remaining exposed to air damages the integrity of the tissue and the subsequent morphology when examining the slide at the microscope.        2) The ratio sample/fixative, according to literature (“Tissue handling and specimen preparation in surgical pathology” Stephen M. Hewitt etc) of 1:10 in weight or volume cannot be defined as containers are prefilled and specimens are not weighed, i.e. the volume of fixative in the prefilled container is preset independent of the weight of the biospecimen. In practice, the average ratio sample/fixative is about 1:20 to 1:25.        3) Standard containers are heavy and bulky. The containers have plastic lids which do not perfectly seal the containers. Thus, evaporation of formalin fumes can take place.        4) In case of spilling of a container, the operating room must be closed and sterilization procedure must be carried out.        5) Outside the operation room the containers, with their large volume and weight, must be transferred using separate trolleys from the operating theatre to the histology lab.        
After arrival in the histology lab, the pathologist or the pathologist assistant opens the container under a fume hood and gross the specimen for further processing.
The remaining bulk of the biospecimen is placed back in the container with formalin and, at the end of the shift, transferred in a special storage room for a preset period of time, normally 2 to 3 weeks, for eventual further need. The storage rooms must thus be ventilated.
Some of the disadvantages of this method are as follows:                1) The biospecimens during storage can release fermentation gases which can cause the lid to open and subsequently the formalin evaporates in the atmosphere of the room.        2) Because of the closed containers specimens are difficult to recognize and very bulky to manipulate.        3) Due to mechanical action the lid can open sometime and causes evaporation of formalin in the atmosphere. This may result in the biospecimens to dry out and thus to damage their morphology.        4) When biospecimens contains air (e.g. lung) the specimen can float on the surface and therefore not all surfaces are wetted by the fixative.        
EP 2 070 410 A1 shows a method for preserving a fresh biospecimens under vacuum in a sealed bag which is filled with a protective gas when the minimum vacuum level is reached. The specimens are kept at 4° C. and transferred to the histology lab. Here the bags are opened and the specimen is grossed as “fresh”.
The specimen must then be fixed in either formalin, a molecular fixative or frozen for tissue banking, according to the requirements of the users.